Stolz A, Harustiak T, Simonek J, Schutzner J, Polanecky O, Burkert J, Lischke R
Neoplasma. 2015;62(3):478-83. doi: 10.4149/neo_2015_057.
The aim of the study was to evaluate type of surgery, long-term survival and factors influencing outcome of pulmonary carcinoid tumors. We reviewed our database of 137 patients surgically treated for typical or atypical carcinoid tumors at our department between 1998 and 2013. There were 95 (69%) patients with typical carcinoid (87 N0, 6 N1, 2 N2) and 42 (31%) with atypical carcinoid (26 N0, 8 N1, 8 N2). Patients with atypical carcinoid were older than those with typical carcinoid (median age of 57±8.1 and 50.5±15.8 years, respectively, p<0.00001). The resection performed consisted of 6 (4.4%) pneumonectomies, 110 (80.1%) lobectomies and bilobectomies, 15 (11%) sleeve lobectomies, 2 (1.5%) resections of main bronchus and 4 (3%) wedge resections. Overall 5- and 10-year survival rates for different tumors were as follows: typical carcinoid: 97.2% and 89.9%, respectively; atypical carcinoid 71.1% and 62.2%, respectively. Statistical analyses indicated that histology (typical carcinoid, p<0.00001), age (less than 45 years, p=0.004) and nodal status (N0, p=0.0002) were significant prognostic factors for better prognosis. Histological sub-type and nodal involvement appear as the most important factors influencing the prognosis. Systemic lymphadenectomy is recommended and should always be performed.
本研究的目的是评估手术类型、长期生存率以及影响肺类癌肿瘤预后的因素。我们回顾了1998年至2013年间在我科接受手术治疗的137例典型或非典型类癌肿瘤患者的数据库。其中95例（69%）为典型类癌（87例N0，6例N1，2例N2），42例（31%）为非典型类癌（26例N0，8例N1，8例N2）。非典型类癌患者比典型类癌患者年龄大（中位年龄分别为57±8.1岁和50.5±15.8岁，p<0.00001）。所进行的切除手术包括6例（4.4%）全肺切除术、110例（80.1%）肺叶切除术和双肺叶切除术、15例（11%）袖状肺叶切除术、2例（1.5%）主支气管切除术以及4例（3%）楔形切除术。不同肿瘤的总体5年和10年生存率如下：典型类癌分别为97.2%和89.9%；非典型类癌分别为71.1%和62.2%。统计分析表明，组织学类型（典型类癌，p<0.00001）、年龄（小于45岁，p=0.004）和淋巴结状态（N0，p=0.0002）是预后较好的显著预后因素。组织学亚型和淋巴结受累似乎是影响预后的最重要因素。建议并应始终进行系统性淋巴结清扫术。
